LETTER
Decreasing Liver Biopsy Complications
Florian Froehlich;
Michael Fried; and
Jean-Jacques Gonvers
1 September 1993 | Volume 119 Issue 5 | Pages 436-437
TO THE EDITOR:
We read with interest the retrospective review by Janes and Lindor [1] on the outcome of patients hospitalized for complications after outpatient liver biopsy. The authors report a complication rate of 3.2%. The varying reported complication rates of liver biopsy may be explained in part by the use of different needle types [2]. Complications have been more frequent with the Tru-Cut (Baxter, Valencia, California) needle than with the Menghini needle [3]. The high complication rate in Janes and Lindor's review, compared with other studies [2, 3], could therefore be caused by the predominant use (92%) of Tru-Cut needles.
Operator experience, known to have a major effect on the complication rate after liver biopsy [4], could also have contributed because 86% of the biopsies were done by fellows. We recently confirmed the importance of training and experience in a nationwide survey in Switzerland [5]. We found that gastroenterologists and internists doing more than 50 biopsies each year had significantly fewer complications when compared with internists doing fewer than 50 biopsies.
1. Janes CH, Lindor KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med. 1993; 118:96-8.
2. Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: How safe is it? Ann Intern Med. 1993; 118:150-3.
3. Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy. A multicenter retrospective study on 68 276 biopsies. J Hepatol. 1986; 2:165-73.
4. Chuah SY, Moody GA, Mayberry JF. The practice, complications and mortality of liver biopsy: a survey amongst members of the British Society of Gastroenterology. Gut. 1992; 33(Suppl):16.
5. Froehlich F, Lamy O, Fried M, Gonvers JJ. Practice and complications of liver biopsy—results of a nationwide survey in Switzerland. Dig Dis Sci. 1993 (In press).
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